| NPI | 1306809769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS7991) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS7991) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2025-07-18 |